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首页> 外文期刊>Journal of Oral and Maxillofacial Surgery >Oral bisphosphonates as a cause of bisphosphonate-related osteonecrosis of the jaws: clinical findings, assessment of risks, and preventive strategies.
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Oral bisphosphonates as a cause of bisphosphonate-related osteonecrosis of the jaws: clinical findings, assessment of risks, and preventive strategies.

机译：口服双膦酸盐是双膦酸盐相关的颌骨坏死的原因：临床发现，风险评估和预防策略。

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PURPOSE: Oral bisphosphonates are known to have potentially profound effects on oral health. A review of the evidence supporting answers to key clinical questions is necessary to assist surgeons in the care of their patients who are receiving oral bisphosphonates. MATERIALS AND METHODS: The literature is reviewed to address several questions, ie, what is the risk of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in my patient on oral bisphosphonates? Why are so few cases of BRONJ attributable to oral bisphosphonate use? What is the importance of cofactors in the development of osteonecrosis? How major a clinical problem is BRONJ, typically, in the oral bisphosphonate patient? What dental procedures are associated with a risk of BRONJ? Are other findings apart from BRONJ of importance in the oral bisphosphonate patient? Are there proven strategies to prevent BRONJ in the oral bisphosphonate patient? Should my patient discontinue the use of oral bisphosphonates temporarily or permanently? RESULTS: A review of the evidence offers information that will help in clinical decision-making. In general, the risk of BRONJ is between 1 in 10,000 and 1 in 100,000, but may increase to 1 in 300 after dental extraction. The great majority of BRONJ cases will likely remain in the intravenous population. Cofactors have not been firmly established, although smoking, steroid use, anemia, hypoxemia, diabetes, infection, and immune deficiency may be important. Rarely does BRONJ in the oral bisphosphonate patient appear to progress beyond stage 2, and many cases reverse with discontinuation of oral medication. Extraction is the only dental procedure shown to increase the risk of BRONJ. Dental implant therapy should be used with caution in the oral bisphosphonate patient. The benefits and risks of oral bisphosphonate use must be weighed individually and in consultation with the prescribing physician, before determining the need for temporary or permanent cessation of medication. CONCLUSION: Emerging evidence supports clinical decisions in favor of the oral and maxillofacial surgery patient taking oral bisphosphonates.
机译：目的：口服双膦酸盐已知对口腔健康具有潜在的深远影响。为了支持外科医生对正在接受口服双膦酸盐治疗的患者进行护理，有必要对支持关键临床问题答案的证据进行审查。材料与方法：文献复习以解决几个问题，即口服双膦酸盐对我的患者双膦酸盐相关的颌骨骨坏死（BRONJ）的风险是什么？为什么很少有BRONJ病例归因于口服双膦酸盐？辅助因子在骨坏死发展中的重要性是什么？通常，口服双膦酸酯类患者的BRONJ有多大的临床问题？哪些牙科手术与BRONJ风险相关？除了BRONJ以外，其他发现是否对口服双膦酸盐患者重要？有口服双膦酸盐类患者预防BRONJ的有效策略吗？我的患者应该暂时或永久停止口服双膦酸盐吗？结果：对证据的审查提供了有助于临床决策的信息。通常，BRONJ的风险在10,000到100,000之间的1至100,000之间，但在拔牙后可能会增加到300的1。大多数BRONJ病例可能会留在静脉内人群中。尽管吸烟，类固醇使用，贫血，低氧血症，糖尿病，感染和免疫缺陷可能很重要，但辅助因子尚未得到明确确定。口服双膦酸盐类药物的BRONJ很少出现超过2期的进展，并且许多情况因停用口服药物而逆转。拔牙是唯一显示会增加BRONJ风险的牙科手术。口服双膦酸盐类药物的患者应谨慎使用牙种植体治疗。在确定是否需要暂时或永久停止用药之前，必须单独权衡口服双膦酸盐的益处和风险，并与处方医生协商。结论：越来越多的证据支持临床决定支持口服双膦酸盐类药物的口腔和颌面外科手术患者。

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